[Federal Register Volume 65, Number 131 (Friday, July 7, 2000)]
[Notices]
[Pages 42021-42022]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-17214]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-77]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration, HHS.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, is 
publishing the following summary of proposed collections for public 
comment. Interested persons are invited to send comments regarding this 
burden estimate or any other aspect of this collection of information, 
including any of the following subjects: (1) The necessity and utility 
of the proposed information collection for the proper performance of 
the agency's functions; (2) the accuracy of the estimated burden; (3) 
ways to enhance the quality, utility, and clarity of the information to 
be collected; and (4) the use of automated collection techniques or 
other forms of information technology to

[[Page 42022]]

minimize the information collection burden.
    Type of Information Collection Request: Extension of a currently 
approved collection;
    Title of Information Collection: Limitation on Liability and 
Information Collection Requirements Referenced in 42 CFR 411.404, 
411.406, and 411.408;
    Form No.: HCFA-R-77 (OMB# 0938-0465);
    Use: The Medicare program requires to provide written notification 
of noncovered services to beneficiaries by the providers, 
practitioners, and suppliers. The notification gives the beneficiary, 
provider, practitioner, or supplier knowledge that Medicare will not 
pay for items or services mentioned in the notification. After this 
notification, any future claim for the same or similar services will 
not be paid by the program and the affected parties will be liable for 
the noncovered services.
    Frequency: Other; as needed;
    Affected Public: Individuals or Households;
    Number of Respondents: 890,826;
    Total Annual Responses: 3,563,304;
    Total Annual Hours: 296,942.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access HCFA's 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and 
HCFA document identifier, to [email protected], or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 60 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address:
    HCFA, Office of Information Services, Security and Standards Group, 
Division of HCFA Enterprise Standards. Attention: Dawn Willinghan, Room 
N2-14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: June 28, 2000.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 00-17214 Filed 7-6-00; 8:45 am]
BILLING CODE 4120-03-P